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Oporia F, Jagnoor J, Mumbya J, Balugaba BE, Businge O, Agenonga J, Walekhwa AW, Isunju JB, Kobusingye O. Lifejackets or just jackets? Seaworthiness of lifejackets sold at landing sites of Lake Albert, Uganda. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024; 30:343-350. [PMID: 38148623 DOI: 10.1080/10803548.2023.2298147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Objectives. Upon immersion in water, a cascade of human physiological responses is evoked, which may result in drowning death. Although lifejackets are over 80% effective in preventing drowning, many people in lakeside fishing communities in Uganda shy away from wearing them because of active distrust in the quality of the lifejackets on the local market. No study has determined the veracity of these claims. This study determined the seaworthiness of lifejackets sold at landing sites of Lake Albert, Uganda. Methods. Using a within-person repeated assessment design, we tested 22 new lifejacket samples obtained from landing sites of Lake Albert, Uganda. We conducted water entry, righting, floatation stability and minimum buoyancy performance tests. Results. All the lifejacket samples failed the minimum buoyancy functional requirements test; the average buoyancy was 80 N (SD 13). Only 4% of the lifejackets passed the righting test within 5 s. For floatation stability, 45% of the lifejackets sank earlier than 48 h of placement in water and also failed water entry tests by getting dislodged from the wearer. Conclusion. The lifejackets sold at the landing sites of Lake Albert do not meet minimum seaworthiness functional requirements. The government should regulate the quality of lifejackets on the local market.
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Affiliation(s)
- Frederick Oporia
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Uganda
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Australia
| | - Jonah Mumbya
- Maritime Administration, Ministry of Works and Transport, Uganda
| | - Bonny Enock Balugaba
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Uganda
| | - Otto Businge
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Uganda
| | - Jeff Agenonga
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Uganda
| | - Abel Wilson Walekhwa
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Uganda
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Uganda
- The George Institute for Global Health, University of New South Wales, Australia
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Pound M, Massey H, Roseneil S, Williamson R, Harper CM, Tipton M, Shawe J, Felton M, Harper JC. How do women feel cold water swimming affects their menstrual and perimenopausal symptoms? Post Reprod Health 2024; 30:11-27. [PMID: 38271095 DOI: 10.1177/20533691241227100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE This study aimed to determine how women felt cold water swimming affected their menstrual and perimenopausal symptoms. STUDY DESIGN An online survey that asked women who regularly swim in cold water about their experiences. The survey was advertised for 2 months on social media. Questions related to cold water swimming habits and menstrual and perimenopausal symptoms were analysed. MAIN OUTCOME MEASURES Quantitative and qualitative data including; frequency of menstrual and menopause symptoms, the effect of cold water swimming on these symptoms. RESULTS 1114 women completed the survey. Women reported that cold water swimming reduced their menstrual symptoms, notably psychological symptoms such as anxiety (46.7%), mood swings (37.7%) and irritability (37.6%). Perimenopausal women reported a significant improvement in anxiety (46.9%), mood swings (34.5%), low mood (31.1%) and hot flushes (30.3%). The majority of women with symptoms swam specifically to reduce these symptoms (56.4% for period and 63.3% for perimenopause symptoms). Women said they felt it was the physical and mental effects of the cold water that helped their symptoms. For the free text question, five themes were identified: the calming and mood-boosting effect of the water, companionship and community, period improvements, an improvement in hot flushes and an overall health improvement. CONCLUSION Women felt that cold water swimming had a positive overall effect on menstrual and perimenopause symptoms. Studies on other forms of exercise to relieve menstrual and perimenopause symptoms may show similar findings.
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Affiliation(s)
- Megan Pound
- EGA Institute for Women's Health, University College London, London, UK
| | - Heather Massey
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | | | | | - C Mark Harper
- University Hospitals Sussex NHS Foundation Trust, Worthing, UK
- Sørlandet Sykehus, Kristiansand, Norway
| | - Mike Tipton
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Jill Shawe
- University of Plymouth and Royal Cornwall Hospitals NHS Trust, Cornwall, UK
| | - Malika Felton
- Department of Rehabilitation and Sport Sciences, Bournemouth University, Poole, UK
| | - Joyce C Harper
- EGA Institute for Women's Health, University College London, London, UK
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Tipton M. Extreme environmental physiology in the dock. Med Leg J 2024:258172231182601. [PMID: 38420761 DOI: 10.1177/00258172231182601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
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Hills SP, Hobbs M, Brown P, Tipton M, Barwood M. Association between air temperature and unintentional drowning risk in the United Kingdom 2012-2019: A nationwide case-crossover study. Prev Med 2024; 179:107832. [PMID: 38145877 DOI: 10.1016/j.ypmed.2023.107832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/18/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE Drowning is a leading cause of death. The World Health Organization (WHO) and United Nations (UN) emphasise the need for population-level data-driven approaches to examine risk factors to improve water safety policies. Weather conditions, have the potential to influence drowning risk behaviours as people are more likely to spend time around water and/or undertake risky activities in aquatic spaces as a behavioural thermoregulatory response (e.g., seeking coolth). METHODS A case-crossover approach assessed associations between changes in daily maximum air temperature (data from the nearest weather station to each drowning event) and unintentional drowning risk using anonymous data from the validated UK Water Incident Database 2012-2019 (1945 unintentional deaths, 82% male). Control days were selected using a unidirectional time-stratified approach, whereby seven and 14 days before the hazard day were used as the controls. RESULTS Mean maximum air temperature on case and control days was 15.36 °C and 14.80 °C, respectively. A 1 °C increase in air temperature was associated with a 7.2% increase in unintentional drowning risk. This relationship existed for males only. Drowning risk was elevated on days where air temperature reached 15-19.9 °C (Odds Ratio; OR: 1.75), 20-24.9 °C (OR: 1.87), and ≥ 25 °C (OR: 4.67), compared with days <10 °C. The greatest elevations in risk appeared to be amongst males and when alcohol intoxication was suspected. Precipitation showed no significant association with unintentional drowning risk. CONCLUSIONS Identifying such relationships highlights the value of considering weather conditions when evaluating environmental risk factors for drowning, and may inform water safety policy and allocating resources to prevention and rescue.
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Affiliation(s)
- Samuel P Hills
- Faculty of Health and Social Sciences, Bournemouth University, United Kingdom.
| | - Matthew Hobbs
- Faculty of Health Sciences, University of Canterbury, Christchurch, Canterbury, New Zealand; GeoHealth Laboratory, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - Paul Brown
- Faculty of Science and Technology, Bournemouth University, United Kingdom
| | - Mike Tipton
- The Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Martin Barwood
- Department of Sport and Wellbeing, Leeds Trinity University, Leeds, United Kingdom
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Giraud D, Pomportes L, Nicol C, Bertin D, Gardarein JL, Hays A. Mechanism involved of post-exercise cold water immersion: Blood redistribution and increase in energy expenditure during rewarming. Temperature (Austin) 2024; 11:137-156. [PMID: 38846524 PMCID: PMC11152100 DOI: 10.1080/23328940.2024.2303332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/03/2024] [Indexed: 06/09/2024] Open
Abstract
Thermogenesis is well understood, but the relationships between cold water immersion (CWI), the post-CWI rewarming and the associated physiological changes are not. This study investigated muscle and systemic oxygenation, cardiorespiratory and hemodynamic responses, and gastrointestinal temperature during and after CWI. 21 healthy men completed randomly 2 protocols. Both protocols consisted of a 48 minutes heating cycling exercise followed by 3 recovery periods (R1-R3), but they differed in R2. R1 lasted 20 minutes in a passive semi-seated position on a physiotherapy table at ambient room temperature. Depending on the protocol, R2 lasted 15 minutes at either ambient condition (R2_AMB) or in a CWI condition at 10°C up to the iliac crest (R2_CWI). R3 lasted 40 minutes at AMB while favoring rewarming after R2_CWI. This was followed by 10 minutes of cycling. Compared to R2_AMB, R2_CWI ended at higherV ˙ O2 in the non-immersed body part due to thermogenesis (7.16(2.15) vs. 4.83(1.62) ml.min-1.kg-1) and lower femoral artery blood flow (475(165) vs. 704(257) ml.min-1) (p < 0.001). Only after CWI, R3 showed a progressive decrease in vastus and gastrocnemius medialis O2 saturation, significant after 34 minutes (p < 0.001). As blood flow did not differ from the AMB protocol, this indicated local thermogenesis in the immersed part of the body. After CWI, a lower gastrointestinal temperature on resumption of cycling compared to AMB (36.31(0.45) vs. 37.30(0.49) °C, p < 0.001) indicated incomplete muscle thermogenesis. In conclusion, the rewarming period after CWI was non-linear and metabolically costly. Immersion and rewarming should be considered as a continuum rather than separate events.
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Affiliation(s)
- Dorian Giraud
- Faculty of Medical and Paramedical Sciences, Aix-Marseille University, HIPE Human Lab, Marseille, France
- Polytech Marseille, Aix-Marseille University, CNRS, IUSTI, Marseille, France
| | - Laura Pomportes
- Faculty of Sport Science, Aix-Marseille University, CNRS, ISM, Marseille, France
| | - Caroline Nicol
- Faculty of Sport Science, Aix-Marseille University, CNRS, ISM, Marseille, France
| | - Denis Bertin
- Faculty of Medical and Paramedical Sciences, Aix-Marseille University, HIPE Human Lab, Marseille, France
- Faculty of Sport Science, Aix-Marseille University, CNRS, ISM, Marseille, France
| | | | - Arnaud Hays
- Faculty of Medical and Paramedical Sciences, Aix-Marseille University, HIPE Human Lab, Marseille, France
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Barwood MJ, Eglin C, Hills SP, Johnston N, Massey H, McMorris T, Tipton MJ, Wakabayashi H, Webster L. Habituation of the cold shock response: A systematic review and meta-analysis. J Therm Biol 2024; 119:103775. [PMID: 38211547 DOI: 10.1016/j.jtherbio.2023.103775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/27/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024]
Abstract
Cold water immersion (CWI) evokes the life-threatening reflex cold shock response (CSR), inducing hyperventilation, increasing cardiac arrhythmias, and increasing drowning risk by impairing safety behaviour. Repeated CWI induces CSR habituation (i.e., diminishing response with same stimulus magnitude) after ∼4 immersions, with variation between studies. We quantified the magnitude and coefficient of variation (CoV) in the CSR in a systematic review and meta-analysis with search terms entered to Medline, SportDiscus, PsychINFO, Pubmed, and Cochrane Central Register. Random effects meta-analyses, including effect sizes (Cohen's d) from 17 eligible groups (k), were conducted for heart rate (HR, n = 145, k = 17), respiratory frequency (fR, n = 73, k = 12), minute ventilation (Ve, n = 106, k = 10) and tidal volume (Vt, n = 46, k=6). All CSR variables habituated (p < 0.001) with large or moderate pooled effect sizes: ΔHR -14 (10) bt. min-1 (d: -1.19); ΔfR -8 (7) br. min-1 (d: -0.78); ΔVe, -21.3 (9.8) L. min-1 (d: -1.64); ΔVt -0.4 (0.3) L -1. Variation was greatest in Ve (control vs comparator immersion: 32.5&24.7%) compared to Vt (11.8&12.1%). Repeated CWI induces CSR habituation potentially reducing drowning risk. We consider the neurophysiological and behavioural consequences.
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Affiliation(s)
- Martin J Barwood
- Faculty of Social and Health Sciences, Leeds Trinity University, Horsforth, UK.
| | - Clare Eglin
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Samuel P Hills
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Nicola Johnston
- Faculty of Social and Health Sciences, Leeds Trinity University, Horsforth, UK
| | - Heather Massey
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Terry McMorris
- Department of Sport and Exercise Science, Institute for Sport, University of Chichester, College Lane, Chichester, West Sussex, UK
| | - Michael J Tipton
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Hitoshi Wakabayashi
- Laboratory of Environmental Ergonomics, Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - Lisa Webster
- Faculty of Social and Health Sciences, Leeds Trinity University, Horsforth, UK
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Notley SR, Mitchell D, Taylor NAS. A century of exercise physiology: concepts that ignited the study of human thermoregulation. Part 3: Heat and cold tolerance during exercise. Eur J Appl Physiol 2024; 124:1-145. [PMID: 37796292 DOI: 10.1007/s00421-023-05276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/04/2023] [Indexed: 10/06/2023]
Abstract
In this third installment of our four-part historical series, we evaluate contributions that shaped our understanding of heat and cold stress during occupational and athletic pursuits. Our first topic concerns how we tolerate, and sometimes fail to tolerate, exercise-heat stress. By 1900, physical activity with clothing- and climate-induced evaporative impediments led to an extraordinarily high incidence of heat stroke within the military. Fortunately, deep-body temperatures > 40 °C were not always fatal. Thirty years later, water immersion and patient treatments mimicking sweat evaporation were found to be effective, with the adage of cool first, transport later being adopted. We gradually acquired an understanding of thermoeffector function during heat storage, and learned about challenges to other regulatory mechanisms. In our second topic, we explore cold tolerance and intolerance. By the 1930s, hypothermia was known to reduce cutaneous circulation, particularly at the extremities, conserving body heat. Cold-induced vasodilatation hindered heat conservation, but it was protective. Increased metabolic heat production followed, driven by shivering and non-shivering thermogenesis, even during exercise and work. Physical endurance and shivering could both be compromised by hypoglycaemia. Later, treatments for hypothermia and cold injuries were refined, and the thermal after-drop was explained. In our final topic, we critique the numerous indices developed in attempts to numerically rate hot and cold stresses. The criteria for an effective thermal stress index were established by the 1930s. However, few indices satisfied those requirements, either then or now, and the surviving indices, including the unvalidated Wet-Bulb Globe-Thermometer index, do not fully predict thermal strain.
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Affiliation(s)
- Sean R Notley
- Defence Science and Technology Group, Department of Defence, Melbourne, Australia
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Duncan Mitchell
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Sciences, University of Western Australia, Crawley, Australia
| | - Nigel A S Taylor
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
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Reed EL, Chapman CL, Whittman EK, Park TE, Larson EA, Kaiser BW, Comrada LN, Wiedenfeld Needham K, Halliwill JR, Minson CT. Cardiovascular and mood responses to an acute bout of cold water immersion. J Therm Biol 2023; 118:103727. [PMID: 37866096 PMCID: PMC10842018 DOI: 10.1016/j.jtherbio.2023.103727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/02/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
Cold water immersion (CWI) may provide benefits for physical and mental health. Our purpose was to investigate the effects of an acute bout of CWI on vascular shear stress and affect (positive and negative). Sixteen healthy adults (age: 23 ± 4 y; (9 self-reported men and 7 self-reported women) completed one 15-min bout of CWI (10 °C). Self-reported affect (positive and negative) was assessed at pre-CWI (Pre), 30-min post-immersion, and 180-min post-immersion in all participants. Brachial artery diameter and blood velocity were measured (Doppler ultrasound) at Pre, after 1-min and 15-min of CWI, and 30-min post-immersion (n = 8). Total, antegrade, and retrograde shear stress, oscillatory shear index (OSI), and forearm vascular conductance (FVC) were calculated. Venous blood samples were collected at Pre, after 1-min and 15-min of CWI, 30-min post-immersion, and 180-min post-immersion (n = 8) to quantify serum β-endorphins and cortisol. Data were analyzed using a one-way ANOVA with Fisher's least significance difference and compared to Pre. Positive affect did not change (ANOVA p = 0.450) but negative affect was lower at 180-min post-immersion (p < 0.001). FVC was reduced at 15-min of CWI and 30-min post-immersion (p < 0.020). Total and antegrade shear and OSI were reduced at 30-min post-immersion (p < 0.040) but there were no differences in retrograde shear (ANOVA p = 0.134). β-endorphins did not change throughout the trial (ANOVA p = 0.321). Cortisol was lower at 180-min post-immersion (p = 0.014). An acute bout of CWI minimally affects shear stress patterns but may benefit mental health by reducing negative feelings and cortisol levels.
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Affiliation(s)
- Emma L Reed
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, USA.
| | - Christopher L Chapman
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, USA.
| | - Emma K Whittman
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, USA.
| | - Talia E Park
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, USA.
| | - Emily A Larson
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, USA.
| | - Brendan W Kaiser
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, USA.
| | - Lindan N Comrada
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, USA.
| | - Karen Wiedenfeld Needham
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, USA.
| | - John R Halliwill
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, USA.
| | - Christopher T Minson
- Bowerman Sports Science Center, Department of Human Physiology, University of Oregon, Eugene, OR, USA.
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Yánez Benñitez C, Lorente-Aznar T, Labaka I, Soteras I, Baselga M, Morishita K, Ribeiro M, Güemes A. Extremity Tourniquet Self-Application by Antarctica Zodiac Crew Members. Disaster Med Public Health Prep 2023; 17:e561. [PMID: 37937358 DOI: 10.1017/dmp.2023.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
Search and rescue teams and Antarctic research groups use protective cold-water anti-exposure suits (AES) when cruising on Zodiacs. Extremity tourniquet (ET) self-application (SA) donned with AESs has not been previously studied. Our study therefore assessed the SA of 5 commercial ETs (CAT, OMNA, RATS, RMT, and SWAT-T) among 15 volunteers who donned these suits. Tourniquet's SA ability, ease of SA, tolerance, and tourniquet preference were measured. All ETs tested were self-applied to the upper extremity except for the SWAT, which was self-applied with the rest to the lower extremity. Ease- of- SA mean values were compared using the Friedman and Durbin-Conover post hoc tests (P < 0.001). Regarding the upper extremity, OMNA achieved the highest score of 8.5 out of 10, while RMT, and SWAT received lower scores than other options (P < 0.001). For lower extremities, SWAT was found to be inferior to other options (P < 0.01). Overall, OMNA was the best performer. The RATS showed significantly lower tolerance than the other groups in repeated- measures ANOVA with a Tukey post hoc test (P < 0.01). Additionally, out of the 5 ETs tested, 60% of subjects preferred OMNA. The study concluded that SA commercial ETs are feasible over cold-water anti-exposure suits in the Antarctic climate.
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Affiliation(s)
- Carlos Yánez Benñitez
- Department of General, GI, and Acute Care Surgery, San Jorge University Hospital, Huesca, Spain
| | - Teófilo Lorente-Aznar
- Department of Primary Care Medicine, Antarctic Expedition, Jaca Health Center, Paseo de la Constitución, Huesca, Spain
| | - Idurre Labaka
- Emergency Medicine, Donostia University Hospital, Donostia, Spain
| | - Iñigo Soteras
- Emergency Medical System (SEM), Department of Medical Science, University of Girona, Girona, Spain
| | - Marta Baselga
- Surgical, Clinical and Experimental Research Group, Institute for Health Research Aragón, University of Zaragoza, San Juan Bosco, Zaragoza, Spain
| | - Koji Morishita
- Department of Acute Critical Care and Disaster Medicine, Tokyo Medical and Dental University Hospital of Medicine, Tokyo, Japan
| | - Marcelo Ribeiro
- Department of Trauma, Burns, Critical Care and Acute Care Surgery, Sheikh Shakhbout Medical City, Abu Dhabi, U.A.E
| | - Antonio Güemes
- Department of General Surgery, Lozano Blesa University Hospital, Zaragoza, Spain
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Oporia F, Kibira SPS, Jagnoor J, Kobusingye O, Makumbi FE, Isunju JB, Nuwaha F. Peer-led training improves lifejacket wear among occupational boaters: Evidence from a cluster randomized controlled trial on Lake Albert, Uganda. PLoS One 2023; 18:e0292754. [PMID: 37862363 PMCID: PMC10588873 DOI: 10.1371/journal.pone.0292754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 09/21/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The burden of drowning among occupational boaters in low and middle-income countries is highest globally. In Uganda, over 95% of people who drowned from boating-related activities were not wearing lifejackets at the time of the incident. We implemented and evaluated a peer-led training program to improve lifejacket wear among occupational boaters on Lake Albert, Uganda. METHODS We conducted a two-arm cluster randomized controlled trial in which fourteen landing sites were randomized to the intervention and non-intervention arm with a 1:1 allocation ratio. In the intervention arm, a six-month peer-to-peer training program on lifejacket wear was implemented while the non-intervention arm continued to receive the routine Marine Police sensitizations on drowning prevention through its community policing program. The effect of the intervention was assessed on self-reported and observed lifejacket wear using a test of differences in proportions of wear following the intention to treat principle. The effect of contamination was assessed using mixed effect modified Poisson regression following the As Treated analysis principle at 95% CI. Results are reported according to the CONSORT statement-extension for cluster randomized trials. RESULTS Self-reported lifejacket wear increased markedly from 30.8% to 65.1% in the intervention arm compared to the non-intervention arm which rose from 29.9% to 43.2%. Observed wear increased from 1.0% to 26.8% in the intervention arm and from 0.6% to 8.8% in the non-intervention arm. The test of differences in proportions of self-reported lifejacket wear (65.1%- 43.2% = 21.9%, p-value <0.001) and observed wear (26.8%- 8.8% = 18%, p-value <0.001) showed statistically significant differences between the intervention and non-intervention arm. Self-reported lifejacket wear was higher among boaters who received peer training than those who did not (Adj. PR 1.78, 95% CI 1.38-2.30). CONCLUSION This study demonstrated that peer-led training significantly improves lifejacket wear among occupational boaters. The government of Uganda through the relevant ministries, and the Landing Site Management Committees should embrace and scale up peer-led training programs on lifejacket wear to reduce drowning deaths.
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Affiliation(s)
- Frederick Oporia
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Simon P. S. Kibira
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Jagnoor Jagnoor
- The George Institute for Global Health, University of New South Wales, Camperdown, New South Wales, Australia
| | - Olive Kobusingye
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
- The George Institute for Global Health, University of New South Wales, Camperdown, New South Wales, Australia
| | - Fredrick Edward Makumbi
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Kampala, Uganda
| | - John Bosco Isunju
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
| | - Fred Nuwaha
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Kampala, Uganda
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Yankouskaya A, Massey H, Totman JJ, Lai LH, Williamson R. The Effects of Whole-body Cold-water Immersion on Brain Connectivity Related to the Affective State in Adults Using fMRI: A Protocol of a Pre-post Experimental Design. Bio Protoc 2023; 13:e4794. [PMID: 37719079 PMCID: PMC10502154 DOI: 10.21769/bioprotoc.4794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/31/2023] [Accepted: 06/03/2023] [Indexed: 09/19/2023] Open
Abstract
An emerging body of behavioural studies indicates that regular swimming in cold water has positive effects on mental health and wellbeing, such as reducing fatigue, improving mood, and lessening depressive symptoms. Moreover, some studies reported immediate effects of cold-water immersion (CWI) on elevating mood and increasing a positive emotional state. However, the neural mechanisms underlying these effects remain largely unknown. The lack of studies using neuroimaging techniques to investigate how a whole-body CWI affects neural processes has partly resulted from the lack of a tested experimental protocol. Previous protocols administered tonic limb cooling (1-10 °C) while recording functional magnetic resonance (fMRI) signals. However, using very low water temperature constitutes points of contrast to painful experiences that are different from what we experience after a whole-body head-out CWI. In our protocol, healthy adults unhabituated to cold water were scanned twice: immediately before (pre-CWI) and after (post-CWI) immersion in cold water (water temperature 20 °C) for 5 min. We recorded cardiac and ventilatory responses to CWI and assessed self-reported changes in positive and negative affects. Our protocol showed reliable changes in brain connectivity after a short exposure to cold water, thus enabling its use as a tested experimental framework in future studies.
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Affiliation(s)
- Ala Yankouskaya
- Department of Psychology, Faculty of Science and
Technology, Poole House, Bournemouth University, Fern Barrow, Poole, Dorset, UK
| | - Heather Massey
- Extreme Environments Laboratory, School of Sport
Health and Exercise Science, Faculty of Science and Heath, Spinnaker Building,
Cambridge Road, Portsmouth, Hampshire, UK
| | - John James Totman
- Department Radiography and Medical Imaging, Fatima
College of Health Sciences, Abu Dhabi, United Arab Emirates
| | - Lin Hui Lai
- Extreme Environments Laboratory, School of Sport
Health and Exercise Science, Faculty of Science and Heath, Spinnaker Building,
Cambridge Road, Portsmouth, Hampshire, UK
| | - Ruth Williamson
- University Hospitals Dorset, NHS Foundation Trust,
Castle Lane East, Bournemouth, UK
- Bournemouth University, Poole House, Fern Barrow,
Poole, Dorset, UK
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12
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Versteeg N, Clijsen R, Hohenauer E. Effects of 3-week repeated cold water immersion on leukocyte counts and cardiovascular factors: an exploratory study. Front Physiol 2023; 14:1197585. [PMID: 37711459 PMCID: PMC10497764 DOI: 10.3389/fphys.2023.1197585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/07/2023] [Indexed: 09/16/2023] Open
Abstract
Aim: This exploratory study aimed to investigate the effects of a 3-week repeated cold water immersion (CWI) intervention on leukocyte counts and cardiovascular factors (mean arterial pressure [MAP], heart rate [HR]) in healthy men. Methods: A total of n = 12, non-cold-adapted men (age: 25.2 ± 4.0 years; height: 177.8 ± 5.6 cm; weight: 73.8 ± 6.5 kg) were randomly allocated to the CWI or control (CON) group. The CWI group underwent a 3-week repeated CWI intervention (12min at 7°C, 4x/week). The CON group did not receive any cold exposure or therapy. Total leukocyte numbers and proportions (neutrophils, basophils, eosinophils, monocytes, lymphocytes) and cardiovascular factors (MAP, HR) were assessed at baseline and after the 3-week intervention period. Results: Total leukocyte count decreased in CWI (p = 0.027, 95% CI -2.35 to -0.20 × 103/µL) and CON (p = 0.043, 95% CI -2.75 to -0.50 × 103/µL). CWI showed a decrease in neutrophil number (p = 0.028, 95% CI -1.55 to -0.25 × 103/µL) and proportion (p = 0.046, 95% CI -6.42 to 0.56%). In contrast, CON showed no significant change (p > 0.05). No differences were found for other leukocyte subtypes in CWI or CON (all p > 0.05). MAP (p = 0.028, 95% CI -17 to -8 mmHg) and HR (p = 0.027, 95% CI -7 to -2 bpm) were reduced in CWI, whereas CON showed no change (p > 0.05). Conclusion: The results suggest no relevant effects of 3-week repeated CWI on leukocyte counts in healthy men. Due to methodological limitations, the effects on the investigated cardiovascular factors remain unclear. Further studies with larger sample sizes are needed to examine the effects on immune function and cardiovascular health.
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Affiliation(s)
- Ninja Versteeg
- Rehabilitation and Exercise Science Laboratory (RESlab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
| | - Ron Clijsen
- Rehabilitation and Exercise Science Laboratory (RESlab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Health, Bern University of Applied Sciences, Berne, Switzerland
| | - Erich Hohenauer
- Rehabilitation and Exercise Science Laboratory (RESlab), Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart, Switzerland
- International University of Applied Sciences THIM, Landquart, Switzerland
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Health, Bern University of Applied Sciences, Berne, Switzerland
- Department of Neurosciences and Movement Science, University of Fribourg, Fribourg, Switzerland
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13
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Wait SO, Charkoudian N, Skinner JW, Smith CJ. Combining hypoxia with thermal stimuli in humans: physiological responses and potential sex differences. Am J Physiol Regul Integr Comp Physiol 2023; 324:R677-R690. [PMID: 36971421 PMCID: PMC10202487 DOI: 10.1152/ajpregu.00244.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/08/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
Increasing prevalence of native lowlanders sojourning to high altitudes (>2,500 m) for recreational, occupational, military, and competitive reasons has generated increased interest in physiological responses to multistressor environments. Exposure to hypoxia poses recognized physiological challenges that are amplified during exercise and further complicated by environments that might include combinations of heat, cold, and high altitude. There is a sparsity of data examining integrated responses in varied combinations of environmental conditions, with even less known about potential sex differences. How this translates into performance, occupational, and health outcomes requires further investigation. Acute hypoxic exposure decreases arterial oxygen saturation, resulting in a reflex hypoxic ventilatory response and sympathoexcitation causing an increase in heart rate, myocardial contractility, and arterial blood pressure, to compensate for the decreased arterial oxygen saturation. Acute altitude exposure impairs exercise performance, for example, reduced time to exhaustion and slower time trials, largely owing to impairments in pulmonary gas exchange and peripheral delivery resulting in reduced V̇o2max. This exacerbates with increasing altitude, as does the risk of developing acute mountain sickness and more serious altitude-related illnesses, but modulation of those risks with additional stressors is unclear. This review aims to summarize and evaluate current literature regarding cardiovascular, autonomic, and thermoregulatory responses to acute hypoxia, and how these may be affected by simultaneous thermal environmental challenges. There is minimal available information regarding sex as a biological variable in integrative responses to hypoxia or multistressor environments; we highlight these areas as current knowledge gaps and the need for future research.
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Affiliation(s)
- Seaver O Wait
- Department of Public Health and Exercise Science, Appalachian State University, Boone, North Carolina, United States
| | - Nisha Charkoudian
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Jared W Skinner
- Department of Public Health and Exercise Science, Appalachian State University, Boone, North Carolina, United States
| | - Caroline J Smith
- Department of Public Health and Exercise Science, Appalachian State University, Boone, North Carolina, United States
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14
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Kelly KR, Palombo LJ, Jensen AE, Bernards JR. Efficacy of closed cell wet-suit at various depths and gas mixtures for thermoprotection during military training dives. Front Physiol 2023; 14:1165196. [PMID: 37293261 PMCID: PMC10245272 DOI: 10.3389/fphys.2023.1165196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/17/2023] [Indexed: 06/10/2023] Open
Abstract
Purpose: To evaluate a closed-cell wet-suit for thermal protective capability during extreme cold water exposure at various depths. Methods: Thirteen (n = 13) elite military divers who were tasked with cold-water training, participated in this study. To mimic various depths, the Ocean Simulation Facility (OSF) at the Navy Experimental Diving Unit (NEDU) was pressurized to simulate dive depths of 30, 50, and 75fsw. Water temperature remained at 1.8-2.0°C for all dives. Four divers dove each day and used the MK16 underwater breathing apparatus with gas mixes of either N202 (79:21) or HeO2 (88:12). Mean skin temperature (TSK) (Ramanathan, 1964), core temperature (Tc), hand and foot readings were obtained every 30 min for 30 and 50fsw and every 15 min during the 75fsw dive. Results: TC was significantly reduced across all dives (p = 0.004); however, was preserved above the threshold for hypothermia (post dive Tc = 36.5 ± 0.4). There was no effect of gas mix on TC. TSK significantly decreased (p < 0.001) across all dives independent of depth and gas. Hand and foot temperatures resulted in the termination of three of the dives. There were no significant main effects for depth or gas, but there were significant main effects for time on hand temperature (p < 0.001) and foot temperature (p < 0.001). Conclusion: Core temperature is maintained above threshold for hypothermia. Variatioins in TC and TSK are a function of dive duration independent of depth or gas for a closed-cell wet-suit in cold water at various depths. However, both hand and foot temperatures reached values at which dexterity is compromised.
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Affiliation(s)
- Karen R. Kelly
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
| | - Laura J. Palombo
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
- Leidos, Inc., San Diego, CA, United States
| | - Andrew E. Jensen
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
- Leidos, Inc., San Diego, CA, United States
| | - Jake R. Bernards
- Applied Translational Exercise and Metabolic Physiology Team, Warfighter Performance, Naval Health Research Center, San Diego, CA, United States
- Leidos, Inc., San Diego, CA, United States
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15
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Skulachev VP, Vyssokikh MY, Chernyak BV, Averina OA, Andreev-Andrievskiy AA, Zinovkin RA, Lyamzaev KG, Marey MV, Egorov MV, Frolova OJ, Zorov DB, Skulachev MV, Sadovnichii VA. Mitochondrion-targeted antioxidant SkQ1 prevents rapid animal death caused by highly diverse shocks. Sci Rep 2023; 13:4326. [PMID: 36922552 PMCID: PMC10017827 DOI: 10.1038/s41598-023-31281-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/09/2023] [Indexed: 03/18/2023] Open
Abstract
The response to stress involves the activation of pathways leading either to protection from the stress origin, eventually resulting in development of stress resistance, or activation of the rapid death of the organism. Here we hypothesize that mitochondrial reactive oxygen species (mtROS) play a key role in stress-induced programmed death of the organism, which we called "phenoptosis" in 1997. We demonstrate that the synthetic mitochondria-targeted antioxidant SkQ1 (which specifically abolishes mtROS) prevents rapid death of mice caused by four mechanistically very different shocks: (a) bacterial lipopolysaccharide (LPS) shock, (b) shock in response to intravenous mitochondrial injection, (c) cold shock, and (d) toxic shock caused by the penetrating cation C12TPP. Importantly, under all these stresses mortality was associated with a strong elevation of the levels of pro-inflammatory cytokines and administration of SkQ1 was able to switch off the cytokine storms. Since the main effect of SkQ1 is the neutralization of mtROS, this study provides evidence for the role of mtROS in the activation of innate immune responses mediating stress-induced death of the organism. We propose that SkQ1 may be used clinically to support patients in critical conditions, such as septic shock, extensive trauma, cooling, and severe infection by bacteria or viruses.
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Affiliation(s)
- V P Skulachev
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia, 119991.
| | - M Yu Vyssokikh
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia, 119991.
| | - B V Chernyak
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia, 119991. .,Institute of Mitoengineering, Lomonosov Moscow State University, Moscow, Russia, 119991.
| | - O A Averina
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia, 119991.,Institute of Mitoengineering, Lomonosov Moscow State University, Moscow, Russia, 119991
| | - A A Andreev-Andrievskiy
- Institute of Mitoengineering, Lomonosov Moscow State University, Moscow, Russia, 119991.,Faculty of Biology, Lomonosov Moscow State University, Moscow, Russia, 119991
| | - R A Zinovkin
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia, 119991.,Institute of Mitoengineering, Lomonosov Moscow State University, Moscow, Russia, 119991
| | - K G Lyamzaev
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia, 119991.,Institute of Mitoengineering, Lomonosov Moscow State University, Moscow, Russia, 119991
| | - M V Marey
- Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia, 117198
| | - M V Egorov
- Institute of Mitoengineering, Lomonosov Moscow State University, Moscow, Russia, 119991
| | - O J Frolova
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia, 119991.,Institute of Mitoengineering, Lomonosov Moscow State University, Moscow, Russia, 119991
| | - D B Zorov
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia, 119991
| | - M V Skulachev
- Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow, Russia, 119991
| | - V A Sadovnichii
- Faculty of Mechanics and Mathematics, Lomonosov Moscow State University, Moscow, Russia, 119991
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16
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Eimonte M, Eimantas N, Baranauskiene N, Solianik R, Brazaitis M. Kinetics of lipid indicators in response to short- and long-duration whole-body, cold-water immersion. Cryobiology 2022; 109:62-71. [PMID: 36150503 DOI: 10.1016/j.cryobiol.2022.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/08/2022] [Accepted: 09/15/2022] [Indexed: 01/16/2023]
Abstract
Cold exposure-induced secretion of stress hormones activates cold-defense responses and mobilizes substrates for increased energy demands to fuel thermogenesis. However, it is unclear whether acute cold exposure-induced stress hormone response kinetics affect circulating lipid parameter kinetics. Therefore, we aimed to investigate the 2-day kinetics of stress hormones (i.e., cortisol, epinephrine, and norepinephrine) and the lipid profile (i.e., total cholesterol [TC], high-density lipoprotein [HDL] cholesterol, low-density lipoprotein [LDL] cholesterol, and triglycerides) in response to whole-body long- (intermittent 170 min; 170-CWI) or short-duration (10 min; 10-CWI) cold-water immersion (CWI; 14 °C water) in 17 healthy, young, adult men. Both CWI trials induced a marked release of the stress hormones, epinephrine, and norepinephrine, with higher concentrations detected after 170-CWI (p < 0.05) and a disrupted diurnal peak of cortisol lasting for a few hours. 170-CWI increased triglyceride levels from immediately after until 2 h after CWI, thereafter the concentration decreased at 4 h, 6 h, 1 day and 2 days after CWI (p < 0.05). Furthermore, the HDL-cholesterol level increased immediately after and at 6 h after 170-CWI (p < 0.05), while TC and LDL-cholesterol levels were not altered within 2 days. Lipid parameters were not affected within the 2 days after 10-CWI. Although both CWIs decreased deep body temperature and increased stress hormone levels for a few hours, only long-duration CWI induced changes in the circulating lipid profile within 2 days after CWI. This should be considered when discussing therapeutic protocols to improve circulating lipid profiles and ameliorate diseases associated with such profiles.
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Affiliation(s)
- Milda Eimonte
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania.
| | - Nerijus Eimantas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Neringa Baranauskiene
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Rima Solianik
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Marius Brazaitis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania.
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17
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Espeland D, de Weerd L, Mercer JB. Health effects of voluntary exposure to cold water - a continuing subject of debate. Int J Circumpolar Health 2022; 81:2111789. [PMID: 36137565 PMCID: PMC9518606 DOI: 10.1080/22423982.2022.2111789] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
This review is based on a multiple database survey on published literature to determine the effects on health following voluntary exposure to cold-water immersion (CWI) in humans. After a filtering process 104 studies were regarded relevant. Many studies demonstrated significant effects of CWI on various physiological and biochemical parameters. Although some studies were based on established winter swimmers, many were performed on subjects with no previous winter swimming experience or in subjects not involving cold-water swimming, for example, CWI as a post-exercise treatment. Clear conclusions from most studies were hampered by the fact that they were carried out in small groups, often of one gender and with differences in exposure temperature and salt composition of the water. CWI seems to reduce and/or transform body adipose tissue, as well as reduce insulin resistance and improve insulin sensitivity. This may have a protective effect against cardiovascular, obesity and other metabolic diseases and could have prophylactic health effects. Whether winter swimmers as a group are naturally healthier is unclear. Some of the studies indicate that voluntary exposure to cold water has some beneficial health effects. However, without further conclusive studies, the topic will continue to be a subject of debate.
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Affiliation(s)
- Didrik Espeland
- Institute of Health Sciences, Department of Medical Biology, UiT The Arctic University of Norway
| | - Louis de Weerd
- Department of Plastic and Reconstructive Surgery, University Hospital of North Norway, Tromsø, Norway,Medical Imaging Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway
| | - James B. Mercer
- Institute of Health Sciences, Department of Medical Biology, UiT The Arctic University of Norway,Medical Imaging Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway,Department of Radiology, University Hospital of North Norway, Tromsø, Norway,CONTACT James B. Mercer Department of Medical Biology, Institute of Health Sciences, UiT The Arctic University of Norway, PO Box 6050 Langnes, N-9037, Tromsø, Norway
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18
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Survival time and search time in water: Past, present and future. J Therm Biol 2022; 110:103349. [DOI: 10.1016/j.jtherbio.2022.103349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 07/24/2022] [Accepted: 09/28/2022] [Indexed: 11/20/2022]
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19
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Tipton M, Massey H, Mayhew A, Morgan P. Cold water therapies: minimising risks. Br J Sports Med 2022; 56:1332-1334. [DOI: 10.1136/bjsports-2022-105953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 11/04/2022]
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20
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Dunn TL, Jones DM, Heaney JH. Cold Entropy: Assessing Individual Differences in Cognitive Adaptability during Cold Stress. ECOLOGICAL PSYCHOLOGY 2022. [DOI: 10.1080/10407413.2022.2055473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Timothy L. Dunn
- Warfighter Performance Department, Naval Health Research Center
| | - Douglas M. Jones
- Warfighter Performance Department, Naval Health Research Center
- Leidos Inc
| | - Jay H. Heaney
- Warfighter Performance Department, Naval Health Research Center
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21
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How to Survive 33 min after the Umbilical of a Saturation Diver Severed at a Depth of 90 msw? Healthcare (Basel) 2022; 10:healthcare10030453. [PMID: 35326931 PMCID: PMC8956028 DOI: 10.3390/healthcare10030453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/11/2022] [Accepted: 02/21/2022] [Indexed: 01/27/2023] Open
Abstract
In 2012, a severe accident happened during the mission of a professional saturation diver working at a depth of 90 m in the North Sea. The dynamic positioning system of the diver support vessel crashed, and the ship drifted away from the working place, while one diver’s umbilical became snagged on a steel platform and was severed. After 33 min, he was rescued into the diving bell, without exhibiting any obvious neurological injury. In 2019, the media and a later ‘documentary’ film suggested that a miracle had happened to permit survival of the diver once his breathing gas supply was limited to only 5 min. Based on the existing data and phone calls with the diver concerned (Dc), the present case report tries to reconstruct, on rational grounds, how Dc could have survived after he was cut off from breathing gas, hot water, light and communication while 90 m deep at the bottom of the sea. Dc carried bail-out heliox (86/14) within two bottles (2 × 12 L × 300 bar: 7200 L). Calculating Dc’s varying per-minute breathing gas consumption over time, both the decreased viscosity of the helium mix and the pressure-related increase in viscosity did not exhibit a breathing gas gap. Based on the considerable respiratory heat loss, the core temperature was calculated to be as low as 28.8 °C to 27.2 °C after recovery in the diving bell. In accordance with the literature, such values would be associated with impaired or lost consciousness, respectively. Relocating Dc on the drilling template by using a remotely operated vehicle (ROV), the transport of the victim to the bell and subsequent care in the hyperbaric chamber must be regarded as exemplary. We conclude that, based on rational arguments and available literature data, Dc’s healthy survival is not a miracle, as it can be convincingly explained by means of reliable data. Remaining with a breathing gas supply sufficient for five minutes only would not have ended in a miracle but would have ended in death by suffocation. Nevertheless, survival of such an accident may appear surprising, and probably the limit for a healthy outcome was very close. We conclude, in addition, that highly effective occupational safety measures, in particular the considerable bail-out heliox reserve, secured the healthy survival. Nevertheless, the victim’s survival is likely to be due to his excellent diving training, together with many years of diving routine. The rescue action of the second diver and Dc’s retrieval by the ROV operator are also suggestive of the behavior of carefully selected crew members with the high degree of professional qualification needed to correctly function in a hostile environment.
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22
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Jackson M, Kang M, Furness J, Kemp-Smith K. Aquatic Exercise and Mental Health: A Scoping Review. Complement Ther Med 2022; 66:102820. [PMID: 35218906 DOI: 10.1016/j.ctim.2022.102820] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/23/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aims of this review were to 1) summarise the breadth and types of research regarding the impact of aquatic exercise on mental health completed to date, 2) provide a clear indication of the intervention type, volume, measurement tools used, and populations best served in relation to this activity and its effectiveness and 3) to identify domains within the literature that can be developed so recommendations can be made for future investigations. METHOD A scoping review was performed under the PRISMA guidelines. A systematic search of Pubmed, SPORTDiscus, PsycInfo and Google Scholar databases was conducted. Studies observing the effect of aquatic exercises on mental health and related parameters were considered for inclusion. The data from the selected studies were then extracted and analysed methodically. PRIMARY CONDITIONS MEASURED Depression, anxiety, mood, self-esteem, and psychological well-being were the primary mental states for which findings could be clearly extracted. RESULTS Of the 1635 articles that resulted from the search, 23 articles met all inclusion criteria. Of these, 12 were randomised controlled trials. Cumulatively, the findings of this review trend towards aquatic exercise being effective in generating positive changes in mental health. CONCLUSION Aquatic exercise, specifically winter swimming, leisure swimming, competitive swimming and aquatic aerobics, can be a promising conservative therapy for mental health management. However, it is recommended that further research be conducted to solidify these findings and establish the long-term effects of this intervention on mental health.
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Affiliation(s)
- Morgan Jackson
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland.
| | - Manjot Kang
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland
| | - James Furness
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland; Water Based Research Unit, Bond University, Gold Coast Queensland
| | - Kevin Kemp-Smith
- Bond Institute of Health and Sport, Bond University, Gold Coast Queensland; Water Based Research Unit, Bond University, Gold Coast Queensland
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23
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Cerebral Blood Flow and Metabolism During Vertical Immersion and In-Water Exercise. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1057262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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24
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Cold for centuries: a brief history of cryotherapies to improve health, injury and post-exercise recovery. Eur J Appl Physiol 2022; 122:1153-1162. [PMID: 35195747 PMCID: PMC9012715 DOI: 10.1007/s00421-022-04915-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/15/2022] [Indexed: 01/01/2023]
Abstract
For centuries, cold temperatures have been used by humans for therapeutic, health and sporting recovery purposes. This application of cold for therapeutic purposes is regularly referred to as cryotherapy. Cryotherapies including ice, cold-water and cold air have been popularised by an ability to remove heat, reduce core and tissue temperatures, and alter blood flow in humans. The resulting downstream effects upon human physiologies providing benefits that include a reduced perception of pain, or analgesia, and an improved sensation of well-being. Ultimately, such benefits have been translated into therapies that may assist in improving post-exercise recovery, with further investigations assessing the role that cryotherapies can play in attenuating the ensuing post-exercise inflammatory response. Whilst considerable progress has been made in our understanding of the mechanistic changes associated with adopting cryotherapies, research focus tends to look towards the future rather than to the past. It has been suggested that this might be due to the notion of progress being defined as change over time from lower to higher states of knowledge. However, a historical perspective, studying a subject in light of its earliest phase and subsequent evolution, could help sharpen one's vision of the present; helping to generate new research questions as well as look at old questions in new ways. Therefore, the aim of this brief historical perspective is to highlight the origins of the many arms of this popular recovery and treatment technique, whilst further assessing the changing face of cryotherapy. We conclude by discussing what lies ahead in the future for cold-application techniques.
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25
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Eimantas N, Ivanove S, Solianik R, Brazaitis M. Exposure to acute noxious heat evokes a cardiorespiratory shock response in humans. Int J Hyperthermia 2022; 39:134-143. [PMID: 35000494 DOI: 10.1080/02656736.2021.2023225] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: Noxious acute cold stimuli cause cold shock via the sympathetic nervous system. However, no studies have investigated respiratory "heat shock" in response to noxious acute heat stimuli (≥ 42 °C).Methods: In the present study, we examined whether short-duration whole-body immersion (for 5 min) in noxious hot water (45 °C) is a sufficient stimulus to induce a respiratory acute shock response.Results and conclusion: Our results indicate that short-duration whole-body immersion in noxious 45 °C water produces a significantly greater body temperature, heart rate, and perceptual and respiratory strain than immersion in innocuous warm 37 °C water (p < .05). The initial first minute of hot water immersion (HWI) at 45 °C (vs. immersion at 37 °C) caused a cardiorespiratory shock response, which manifested as acute hyperventilation, and increased ventilatory tidal volume, respiratory exchange ratio, and heart rate (p < .05). Adjustment to this initial respiratory heat shock response within the first minute of immersion was observed as compared with remaining HWI time (1-5 min). Intriguingly, the time-course kinetics of breathing frequency, oxygen uptake, and carbon dioxide washout did not differ between whole-body immersion at 37 °C and immersion at 45 °C, but were higher than in control thermoneutral conditions of an empty bath (p < .05). This may be because of events initiated not only by the water temperature but also by the change in the hydrostatic pressure acting upon the body when immersed in the water bath.
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Affiliation(s)
- Nerijus Eimantas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Soneta Ivanove
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Rima Solianik
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Marius Brazaitis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
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26
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Massey H, Gorczynski P, Harper CM, Sansom L, McEwan K, Yankouskaya A, Denton H. Perceived Impact of Outdoor Swimming on Health: Web-Based Survey. Interact J Med Res 2022; 11:e25589. [PMID: 34982711 PMCID: PMC8767464 DOI: 10.2196/25589] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 10/19/2021] [Accepted: 11/17/2021] [Indexed: 11/24/2022] Open
Abstract
Background Outdoor swimming in lakes, lidos (outdoor pools), rivers, and the sea has grown in popularity in many countries, including the United Kingdom. Many anecdotal accounts indicate improvements in medical conditions, which are considered a consequence of outdoor swimming. Objective The aim of this study is to better understand outdoor swimmers’ perceptions of their health and the extent to which participation impacted their existing self-reported symptoms. Methods A survey was conducted to investigate outdoor swimming behaviors and reports of any diagnosed medical conditions. Medical conditions were coded into categories, and descriptive statistics were generated regarding the outdoor swimmers’ behaviors and the effect that outdoor swimming had on their medical symptoms if any. The medical categories were clustered into five larger categories based on their prevalence in the current sample: mental health; musculoskeletal and injury; neurological; cardiovascular and blood disease; and other, which comprises inflammatory, immune, endocrine, and respiratory conditions. Results In total, 722 outdoor swimmers responded, of whom 498 (68.9%) were female. The probability of outdoor swimming having some positive impact on health across all medical categories was 3.57 times higher compared with no impact (B=1.28, 95% CI 0.63-1.91; P<.001), 44.32 times higher for the mental health category (B=3.79, 95% CI 2.28-5.30; P<.001), 5.25 times higher for musculoskeletal and injury category (B=1.66, 95% CI 0.52-2.79; P=.004), and 4.02 times higher for the other category (B=1.39, 95% CI 0.27-2.51; P=.02). Overall, outdoor swimming was associated with perceived reductions in symptoms of poor mental health (χ22=25.1; P<.001), musculoskeletal and injury (χ22=8.2; P=.04), cardiovascular and blood (χ22=14.7; P=.006), and other conditions (χ22=18.2; P<.001). Conclusions Physical activity in the form of outdoor swimming is perceived to have positive impacts on health and is associated with perceived symptom reductions in mental health, musculoskeletal and injury, and cardiovascular and blood conditions. This study cannot provide causal relationships or provide mechanistic insights. However, it does provide a starting point for more targeted prospective intervention research into individual conditions or categories of conditions to establish the impact in those who choose to start outdoor swimming.
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Affiliation(s)
- Heather Massey
- Extreme Environments Laboratory, School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Paul Gorczynski
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - C Mark Harper
- Department of Anaesthesia, Royal Sussex County Hospital, Brighton, United Kingdom.,Department of Anaesthesia, Sørlandet Sykehus, Kristiansand, Norway
| | - Lisa Sansom
- Public Health Department, East Sussex County Council, Lewes, United Kingdom.,NHS Primary Care, Hastings, United Kingdom
| | - Kieren McEwan
- School of Sport, Health and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Alla Yankouskaya
- Department of Psychology, Faculty of Science and Technology, Bournemouth University, Bournemouth, United Kingdom
| | - Hannah Denton
- West Recovery Team, Mill View Hospital, Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
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27
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Kelly JS, Bird E. Improved mood following a single immersion in cold water. LIFESTYLE MEDICINE 2021. [DOI: 10.1002/lim2.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- John S. Kelly
- Institute of Sport, Nursing and Allied Health University of Chichester Chichester UK
| | - Ellis Bird
- Institute of Sport, Nursing and Allied Health University of Chichester Chichester UK
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28
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Abstract
Internationally, drowning is a leading cause of accidental death that features in many legal cases. In these cases, possible mitigations and the ‘pain and suffering’ in terms of the duration and subjective experience of drowning are often pivotal in determining levels of compensation and outcome. As a result, there is a requirement to understand the stages of the drowning process, and the duration and physiological and subjective responses associated with each stage. In this short review we focus on these issues.
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Affiliation(s)
- Michael Tipton
- Extreme Environments Laboratory, School of Sport, Health & Exercise Sciences, University of Portsmouth, Portsmouth, UK
| | - Hugh Montgomery
- Centre for Human Health and Performance, University College London, London, UK
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29
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Castellani JW, Eglin CM, Ikäheimo TM, Montgomery H, Paal P, Tipton MJ. ACSM Expert Consensus Statement: Injury Prevention and Exercise Performance during Cold-Weather Exercise. Curr Sports Med Rep 2021; 20:594-607. [PMID: 34752434 DOI: 10.1249/jsr.0000000000000907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
ABSTRACT Cold injury can result from exercising at low temperatures and can impair exercise performance or cause lifelong debility or death. This consensus statement provides up-to-date information on the pathogenesis, nature, impacts, prevention, and treatment of the most common cold injuries.
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Affiliation(s)
- John W Castellani
- United States Army Research Institute of Environmental Medicine, Thermal and Mountain Medicine Division, Natick, MA
| | - Clare M Eglin
- University of Portsmouth, School of Sport, Health and Exercise Science, Portsmouth, United Kingdom
| | | | - Hugh Montgomery
- University College London, Centre for Human Health and Performance, London, United Kingdom
| | - Peter Paal
- Hospitallers Brothers Hospital, Anaesthesiology and Intensive Care Medicine, Salzburg, Austria
| | - Michael J Tipton
- University of Portsmouth, School of Sport, Health and Exercise Science, Portsmouth, United Kingdom
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30
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Hills SP, Hobbs M, Tipton MJ, Barwood MJ. The water incident database (WAID) 2012 to 2019: a systematic evaluation of the documenting of UK drownings. BMC Public Health 2021; 21:1760. [PMID: 34579685 PMCID: PMC8474860 DOI: 10.1186/s12889-021-11827-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/09/2021] [Indexed: 11/30/2022] Open
Abstract
Background Death by drowning is a leading cause of accidental death in the United Kingdom (UK) and worldwide. The World Health Organization (WHO) states that effective documentation of drowning is required to describe drowning frequency and to underpin effective drowning prevention intervention, thus improving the quality of data describing drowning frequency represents a key initiative. The water incident database (WAID) has been used to document UK fatal and non-fatal water-based incidents since 2009. WAID has not undergone a systematic evaluation of its data or data collection procedures to establish if the database meets the WHO requirements. The present study investigated the characteristics of UK fatal drowning incidents and audited current WAID data capture procedures. Methods Data for the fatal drowning cases recorded between 2012 and 2019 were reviewed. Descriptive data were generated 1) to describe fatal drownings in the UK’s WAID in this period; 2) a sub-set of drownings were audited i) for completeness of data entry and, based on source documents, ii) for quality of data entry; 3) these processes were used to make recommendations for onward revisions to WAID. Results A total of 5051 fatalities were recorded between 2012 and 2019. Drowning was most frequent amongst males aged 35 to 60 years (n = 1346), whilst suspected accidents and suicides accounted for 44 and 35% of fatalities. Suicide by drowning was at a peak in the most recent year of data analysed (i.e., 2019; 279 cases) highlighting an urgent need for targeted intervention. Audit part 2i) indicated that 16% of all fields were incomplete, thus indicating potential redundancy, duplication, or the need for onward review. Audit part 2ii) indicated high levels of agreement (80 ± 12%) between audited cases and the ‘true’ WAID entries. Conclusions This study confirms WAID as a rigorous, transparent and effective means of documenting UK drownings thereby meeting WHO requirements for data quality; yet future improvements are recommended. Such findings allow researchers and policy makers to use WAID to further investigate UK drowning with a view to improving public safety measures and drowning prevention interventions. Observations alongside several expert recommendations have informed a revised version of WAID.
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Affiliation(s)
- Samuel P Hills
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, BH12 5BB, UK
| | - Matthew Hobbs
- School of Health Sciences, College of Education, Health and Human Development, University of Canterbury, Christchurch, New Zealand.,GeoHealth Laboratory, University of Canterbury, Christchurch, New Zealand
| | - Michael J Tipton
- The Extreme Environments Laboratory, Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, PO1 2ER, UK.,International Drowning Researchers' Alliance, Kuna, ID, USA
| | - Martin J Barwood
- International Drowning Researchers' Alliance, Kuna, ID, USA. .,Department of Sport, Health and Nutrition, Leeds Trinity University, Brownberrie Lane, Horsforth, Leeds, West Yorkshire, LS18 5HD, UK.
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31
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Eimonte M, Paulauskas H, Daniuseviciute L, Eimantas N, Vitkauskiene A, Dauksaite G, Solianik R, Brazaitis M. Residual effects of short-term whole-body cold-water immersion on the cytokine profile, white blood cell count, and blood markers of stress. Int J Hyperthermia 2021; 38:696-707. [PMID: 33910456 DOI: 10.1080/02656736.2021.1915504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background: One of the most challenging environmental extremes is immersion in cold/icy water, and consequent common assumption is that even a brief exposure to cold can lead to cold-related illnesses. The increase in the concentrations of the stress hormones cortisol, epinephrine (Epi), and norepinephrine (NE) in response to acute cold stress are thought to suppress the release of proinflammatory cytokines. No previous study has explored the residual consequences of whole-body short-term cold-water immersion (CWI; 14 °C for 10 min) on the immune response in healthy non-acclimated young adult men (aged 20-30 years).Materials and methods: In the current study, we tested the hypothesis that short-term acute whole-body CWI would induce high blood levels of cortisol, NE, and Epi, which in turn would increase circulating leukocyte numbers and delay the production of proinflammatory cytokines (tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and IL-6). Results: Short-term whole-body CWI produced a stressful physiological reaction, as manifested by hyperventilation and increased muscle shivering, metabolic heat production, and heart rate. CWI also induced the marked release of the stress hormones Epi, NE, and cortisol. The change in IL-6 concentration after CWI was delayed and TNF-α production was decreased, but IL-1β was not affected within 48 h after CWI. A delayed increase in neutrophil percentage and decrease in lymphocyte percentage occurred after CWI.Conclusion: These findings suggest that, even though CWI caused changes in stress and immune markers, the participants showed no predisposition to symptoms of the common cold within 48 h after CWI.
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Affiliation(s)
- Milda Eimonte
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Henrikas Paulauskas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Laura Daniuseviciute
- Faculty of Social Sciences, Arts and Humanities, Kaunas University of Technology, Kaunas, Lithuania
| | - Nerijus Eimantas
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Astra Vitkauskiene
- Department of Laboratory Medicine, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintare Dauksaite
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Rima Solianik
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - Marius Brazaitis
- Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
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32
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Ackermann S, Laborde S, Borges U, Mosley E. Commentary: Photoplethysmography for Quantitative Assessment of Sympathetic Nerve Activity (SNA) During Cold Stress. Front Physiol 2021; 12:602745. [PMID: 34248652 PMCID: PMC8262254 DOI: 10.3389/fphys.2021.602745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 05/21/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
- Stefan Ackermann
- Institute of Psychology, Department of Performance Psychology, German Sport University Cologne, Cologne, Germany
| | - Sylvain Laborde
- Institute of Psychology, Department of Performance Psychology, German Sport University Cologne, Cologne, Germany.,Normandie Université Caen, UFR STAPS, EA 4260, Normandy, France
| | - Uirassu Borges
- Institute of Psychology, Department of Performance Psychology, German Sport University Cologne, Cologne, Germany.,Institute of Psychology, Department of Health and Social Psychology, German Sport University Cologne, Cologne, Germany
| | - Emma Mosley
- Department of Sport Science and Performance, Southampton Solent University, Southampton, United Kingdom
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33
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Yurkevicius BR, Alba BK, Seeley AD, Castellani JW. Human cold habituation: Physiology, timeline, and modifiers. Temperature (Austin) 2021; 9:122-157. [PMID: 36106151 PMCID: PMC9467574 DOI: 10.1080/23328940.2021.1903145] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Habituation is an adaptation seen in many organisms, defined by a reduction in the response to repeated stimuli. Evolutionarily, habituation is thought to benefit the organism by allowing conservation of metabolic resources otherwise spent on sub-lethal provocations including repeated cold exposure. Hypermetabolic and/or insulative adaptations may occur after prolonged and severe cold exposures, resulting in enhanced cold defense mechanisms such as increased thermogenesis and peripheral vasoconstriction, respectively. Habituation occurs prior to these adaptations in response to short duration mild cold exposures, and, perhaps counterintuitively, elicits a reduction in cold defense mechanisms demonstrated through higher skin temperatures, attenuated shivering, and reduced cold sensations. These habituated responses likely serve to preserve peripheral tissue temperature and conserve energy during non-life threatening cold stress. The purpose of this review is to define habituation in general terms, present evidence for the response in non-human species, and provide an up-to-date, critical examination of past studies and the potential physiological mechanisms underlying human cold habituation. Our aim is to stimulate interest in this area of study and promote further experiments to understand this physiological adaptation.
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Affiliation(s)
- Beau R. Yurkevicius
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Billie K. Alba
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
| | - Afton D. Seeley
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
- Oak Ridge Institute of Science and Education, Belcamp, MD, USA
| | - John W. Castellani
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine, Natick, MA, USA
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34
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Raiko JRH, Saari T, Orava J, Savisto N, Parkkola R, Haaparanta-Solin M, Nuutila P, Virtanen KA. Changes in electrocardiogram parameters during acute nonshivering cold exposure and associations with brown adipose tissue activity, plasma catecholamine levels, and brachial blood pressure in healthy adults. Physiol Rep 2021; 9:e14718. [PMID: 33580902 PMCID: PMC7881801 DOI: 10.14814/phy2.14718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/12/2020] [Accepted: 12/19/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Sympathetic activity causes changes in electrocardiogram (ECG) during cold exposure and the changes have been studied mostly during hypothermia and less during mild acute nonshivering cold exposure. Cold-induced sympathetic activity also activates brown adipose tissue (BAT) and increases arterial blood pressure (BP) and plasma catecholamine levels. We examined changes in ECG parameters during acute nonshivering cold exposure and their associations with markers of sympathetic activity during cold exposure: brachial blood pressure (BP), plasma catecholamine levels, and BAT activity measured by positron emission tomography (PET). METHODS AND RESULTS Healthy subjects (M/F = 13/24, aged 20-55 years) were imaged with [15 O]H2 O (perfusion, N = 37) and [18 F]FTHA to measure plasma nonesterified fatty acid uptake (NEFA uptake, N = 37) during 2-h nonshivering cold exposure. 12-lead ECG (N = 37), plasma catecholamine levels (N = 17), and brachial BP (N = 31) were measured at rest in room temperature (RT) and re-measured after a 2-h nonshivering cold exposure. There were significant differences between RT and cold exposure in P axis (35.6 ± 26.4 vs. 50.8 ± 22.7 degrees, p = 0.005), PR interval (177.7 ± 24.6 ms vs.163.0 ± 28.7 ms, p = 0.001), QRS axis (42.1 ± 31.3 vs. 56.9 ± 24.1, p = 0.003), and QT (411.7 ± 25.5 ms vs. 434.5 ± 39.3 ms, p = 0.001). There was no significant change in HR, QRS duration, QTc, JTc, and T axis during cold exposure. Systolic BP (127.2 ± 15.7 vs. 131.8 ± 17.9 mmHg, p = 0.008), diastolic BP (81.7 ± 12.0 vs. 85.4 ± 13.0 mmHg, p = 0.02), and plasma noradrenaline level increased during cold exposure (1.97 ± 0.61 vs. 5.07 ± 1.32 µmol/L, p = 0.001). Cold-induced changes in ECG parameters did not correlate with changes in BAT activity, brachial BP, plasma catecholamines, or skin temperature. CONCLUSIONS During short-term nonshivering cold exposure, there were increases in P axis, PR interval, QRS axis, and QT compared to RT in healthy adults. Cold-induced changes in ECG parameters did not correlate with BAT activity, brachial BP, or plasma catecholamine levels which were used as markers of cold-induced sympathetic activity.
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Affiliation(s)
- Juho R H Raiko
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Teemu Saari
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Janne Orava
- Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Nina Savisto
- Turku PET Centre, University of Turku, Turku, Finland
| | - Riitta Parkkola
- Turku PET Centre, Turku University Hospital, Turku, Finland.,Department of Radiology, Turku University Hospital and University of Turku, Turku, Finland
| | | | - Pirjo Nuutila
- Turku PET Centre, Turku University Hospital, Turku, Finland.,Department of Endocrinology, Turku University Hospital, Turku, Finland
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35
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Knechtle B, Stjepanovic M, Knechtle C, Rosemann T, Sousa CV, Nikolaidis PT. Physiological Responses to Swimming Repetitive "Ice Miles". J Strength Cond Res 2021; 35:487-494. [PMID: 29878984 DOI: 10.1519/jsc.0000000000002690] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Knechtle, B, Stjepanovic, M, Knechtle, C, Rosemann, T, Sousa, CV, and Nikolaidis, PT. Physiological responses to swimming repetitive "Ice Miles." J Strength Cond Res 35(2): 487-494, 2021-"Ice Mile" swimming (i.e., 1,608 m in water of below 5° C) is becoming increasingly popular. Since the foundation of the International Ice Swimming Association (IISA) in 2009, official races are held as World Cup Races and World Championships. Ice swimming was a demonstration sport at the 2014 Winter Olympics in Sochi, Russia. This case study aimed to identify core body temperature and selected hematological and biochemical parameters before and after repeated "Ice Miles." An experienced ice swimmer completed 6 consecutive Ice Miles within 2 days. Three Ice Miles adhered to the strict criteria for the definition of Ice Miles, whereas the other 3 were very close (i.e., 5.2, 6.1, and 6.6° C) to the temperature limit. Swimming times, changes in core body temperatures, and selected urinary and hematological parameters were recorded. The athlete showed after each Ice Mile a metabolic acidosis (i.e., an increase in lactate and TCO2; a decrease in base excess and HCO3-) and an increase in blood glucose, cortisol, and creatine kinase concentration. The decrease in pH correlated significantly and negatively with the increase in cortisol level, indicating that this intense exercise causes a metabolic stress. The change in core body temperature between start and finish was negatively associated with metabolic acidosis. The increase in creatine kinase suggests skeletal muscle damages due to shivering after an Ice Mile. For athletes and coaches, swimming in cold water during Ice Miles leads to a metabolic acidosis, which the swimmer tries to compensate with a respiratory response. Considering the increasing popularity of ice swimming, the findings have practical value for swimmers and practitioners (e.g., coaches, exercise physiologists, and physicians) working with them because our results provide a detailed description of acute physiological responses to repeated swimming in cold conditions. These findings are of importance for athletes and coaches for National Championships and World Championships in Ice Swimming following the IISA rules.
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Affiliation(s)
- Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Mirko Stjepanovic
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | | | - Thomas Rosemann
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Caio V Sousa
- Graduate Program in Physical Education, Catholic University of Brasília, Brasília, Brazil ; and
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Taylor NAS, Lee JY, Kim S, Notley SR. Physiological interactions with personal-protective clothing, physically demanding work and global warming: An Asia-Pacific perspective. J Therm Biol 2021; 97:102858. [PMID: 33863427 DOI: 10.1016/j.jtherbio.2021.102858] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 01/03/2023]
Abstract
The Asia-Pacific contains over half of the world's population, 21 countries have a Gross Domestic Product <25% of the world's largest economy, many countries have tropical climates and all suffer the impact of global warming. That 'perfect storm' exacerbates the risk of occupational heat illness, yet first responders must perform physically demanding work wearing personal-protective clothing and equipment. Unfortunately, the Eurocentric emphasis of past research has sometimes reduced its applicability to other ethnic groups. To redress that imbalance, relevant contemporary research has been reviewed, to which has been added information applicable to people of Asian, Melanesian and Polynesian ancestry. An epidemiological triad is used to identify the causal agents and host factors of work intolerance within hot-humid climates, commencing with the size dependency of resting metabolism and heat production accompanying load carriage, followed by a progression from the impact of single-layered clothing through to encapsulating ensembles. A morphological hypothesis is presented to account for inter-individual differences in heat production and heat loss, which seems to explain apparent ethnic- and gender-related differences in thermoregulation, at least within thermally compensable states. The mechanisms underlying work intolerance, cardiovascular insufficiency and heat illness are reviewed, along with epidemiological data from the Asia-Pacific. Finally, evidence-based preventative and treatment strategies are presented and updated concerning moisture-management fabrics and barriers, dehydration, pre- and post-exercise cooling, and heat adaptation. An extensive reference list is provided, with >25 recommendations enabling physiologists, occupational health specialists, policy makers, purchasing officers and manufacturers to rapidly extract interpretative outcomes pertinent to the Asia-Pacific.
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Affiliation(s)
- Nigel A S Taylor
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
| | - Joo-Young Lee
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Siyeon Kim
- Human Convergence Technology R&D Department, Korea Institute of Industrial Technology, Ansan, Republic of Korea
| | - Sean R Notley
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
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37
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Does Cold-Water Endurance Swimming Affect Pulmonary Function in Healthy Adults? Sports (Basel) 2021; 9:sports9010007. [PMID: 33435240 PMCID: PMC7828093 DOI: 10.3390/sports9010007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/26/2020] [Accepted: 01/06/2021] [Indexed: 12/22/2022] Open
Abstract
The acute effects of cold-water endurance swimming on the respiratory system have received little attention. We investigated pulmonary responses to cold-water endurance swimming in healthy recreational triathletes. Pulmonary function, alveolar diffusing capacity (DLCO), fractional exhaled nitric oxide (FENO) and arterial oxygen saturation by pulse oximetry (SpO2) were assessed in 19 healthy adults one hour before and 2.5 h after a cold-water (mean ± SD, 10 ± 0.9 °C) swim trial (62 ± 27 min). In addition, 12 out of the 19 participants measured pulmonary function, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) 3, 10, 20 and 45 min post-swim by maximal expiratory flow volume loops and DLCO by the single breath technique. FVC and FEV1 were significantly reduced 3 min post-swim (p = 0.02) (p = 0.04), respectively, and five of 12 participants (42%) experienced exercise-induced bronchoconstriction (EIB), defined as a ≥ 10% drop in FEV1. No significant changes were observed in pulmonary function 2.5 h post-swim. However, mean FENO and DLCO were significantly reduced by 7.1% and 8.1% (p = 0.01) and (p < 0.001), respectively, 2.5 h post-swim, accompanied by a 2.5% drop (p < 0.001) in SpO2. The absolute change in DLCO correlated significantly with the absolute decline in core temperature (r = 0.52; p = 0.02). Conclusion: Cold-water endurance swimming may affect the lungs in healthy recreational triathletes lasting up to 2.5 h post-swim. Some individuals appear to be more susceptible to pulmonary impairments than others, although these mechanisms need to be studied further.
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38
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Knechtle B, Waśkiewicz Z, Sousa CV, Hill L, Nikolaidis PT. Cold Water Swimming-Benefits and Risks: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8984. [PMID: 33276648 PMCID: PMC7730683 DOI: 10.3390/ijerph17238984] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 11/14/2020] [Accepted: 11/30/2020] [Indexed: 12/16/2022]
Abstract
Cold water swimming (winter or ice swimming) has a long tradition in northern countries. Until a few years ago, ice swimming was practiced by very few extreme athletes. For some years now, ice swimming has been held as competitions in ice-cold water (colder than 5 °C). The aim of this overview is to present the current status of benefits and risks for swimming in cold water. When cold water swimming is practiced by experienced people with good health in a regular, graded and adjusted mode, it appears to bring health benefits. However, there is a risk of death in unfamiliar people, either due to the initial neurogenic cold shock response or due to a progressive decrease in swimming efficiency or hypothermia.
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Affiliation(s)
- Beat Knechtle
- Medbase St. Gallen Am Vadianplatz, 9000 St. Gallen, Switzerland;
| | - Zbigniew Waśkiewicz
- Institute of Sport Science, Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland;
- Department of Sports Medicine and Medical Rehabilitation Moscow, Sechenov First Moscow State Medical University, 19c1 Moscow, Russia
| | - Caio Victor Sousa
- Bouve College of Health Sciences, Northeastern University, Boston, MA 02115, USA;
| | - Lee Hill
- Division of Gastroenterology & Nutrition, Department of Pediatrics, McMaster University, Hamilton, ON L8N 3Z5, Canada;
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Keramidas ME, Kölegård R, Eiken O. Hypoxia gradually augments metabolic and thermoperceptual responsiveness to repeated whole-body cold stress in humans. Exp Physiol 2020; 105:2123-2140. [PMID: 33140429 PMCID: PMC7756580 DOI: 10.1113/ep089070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 10/30/2020] [Indexed: 12/02/2022]
Abstract
New Findings What is the central question of this study? In male lowlanders, does hypoxia modulate thermoregulatory effector responses during repeated whole‐body cold stress encountered in a single day? What is the main finding and its importance? A ∼10 h sustained exposure to hypoxia appears to mediate a gradual upregulation of endogenous heat production, preventing the progressive hypothermic response prompted by serial cold stimuli. Also, hypoxia progressively degrades mood, and compounds the perceived thermal discomfort, and sensations of fatigue and coldness.
Abstract We examined whether hypoxia would modulate thermoeffector responses during repeated cold stress encountered in a single day. Eleven men completed two ∼10 h sessions, while breathing, in normobaria, either normoxia or hypoxia (PO2: 12 kPa). During each session, subjects underwent sequentially three 120 min immersions to the chest in 20°C water (CWI), interspersed by 120 min rewarming. In normoxia, the final drop in rectal temperature (Trec) was greater in the third (∼1.2°C) than in the first and second (∼0.9°C) CWIs (P < 0.05). The first hypoxic CWI augmented the Trec fall (∼1.2°C; P = 0.002), but the drop in Trec did not vary between the three hypoxic CWIs (P = 0.99). In normoxia, the metabolic heat production (M˙) was greater during the first half of the third CWI than during the corresponding part of the first CWI (P = 0.02); yet the difference was blunted during the second half of the CWIs (P = 0.89). In hypoxia, by contrast, the increase in M˙ was augmented by ∼25% throughout the third CWI (P < 0.01). Regardless of the breathing condition, the cold‐induced elevation in mean arterial pressure was blunted in the second and third CWI (P < 0.05). Hypoxia aggravated the sensation of coldness (P = 0.05) and thermal discomfort (P = 0.04) during the second half of the third CWI. The present findings therefore demonstrate that prolonged hypoxia mediates, in a gradual manner, metabolic and thermoperceptual sensitization to repeated cold stress.
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Affiliation(s)
- Michail E Keramidas
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Roger Kölegård
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Ola Eiken
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
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Ventilatory responses to whole body cryotherapy. J Therm Biol 2020; 91:102633. [PMID: 32716875 DOI: 10.1016/j.jtherbio.2020.102633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 05/21/2020] [Accepted: 05/27/2020] [Indexed: 11/22/2022]
Abstract
The effects of whole body cryotherapy (WBC) on measures of respiratory function, and their interaction with sex and anthropometry, are unknown. This study investigated ventilatory responses after WBC and examined the role of sex and anthropometric characteristics in 22 recreationally active male and female participants. Thermal sensation [TS], heart rate, blood pressure and ventilatory measures (expired volume [V˙E], oxygen consumption [V˙O2], respiratory exchange ratio and metabolic equivalents of task [METS]) were evaluated pre- and post-WBC, compared to a control condition. V˙E increased by 10.8 L.min-1 following WBC compared to 0.1 L.min-1 in the control session (p=.001). V˙O2 increased by 0.4 L.min-1 following WBC compared to 0.0 L.min-1 in the control session (p<.001). METS increased by 1.0 following WBC compared to 0.1 in the control session (p<.001). TS decreased by 2 following WBC compared to 0 in the control session (p<.001), with females' TS decreasing significantly more than males following WBC (p=.001). Following a WBC exposure, highly significant strong negative relationships were observed between fat mass index and ΔV˙O2 (p=.002, r=-.718), body fat percentage and ΔV˙O2 (p=.003, r=-.700), fat mass index and ΔMETS (p=.001, r=-.729), body fat percentage and ΔMETS (p=.004, r=-.676). Furthermore, strong, statistically significant positive correlations were observed following a WBC exposure between BSA to mass ratio and TS (p=.005, r=-.669), TS and BSA (p<0.001, r=.776) and fat free mass index and TS (p=.001, r=.745). A short exposure to WBC elicits a ventilatory response via increased V˙O2, V˙E and METS. The largest increases occur within the first minute post-exposure, but return to near resting levels 1 min post-WBC. Increases in V˙O2, V˙E and METS observed post-WBC are likely due to an acute transient shivering response due to cold air exposure.
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Jones D, Bowles J, Bergquist-Turori D, Cooper C, Rostomily K, Pautz C, Heaney J. Evaluation of Three Field Rewarming Techniques During Cold Weather Military Training. Wilderness Environ Med 2020; 31:285-290. [PMID: 32682705 DOI: 10.1016/j.wem.2020.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 04/02/2020] [Accepted: 04/05/2020] [Indexed: 12/01/2022]
Abstract
INTRODUCTION The purpose of this work was to evaluate the effectiveness of 3 rewarming techniques to determine how warfighters, and perhaps other populations in wilderness environments, should prioritize field rewarming options after a brief accidental immersion in cold water. METHODS As part of a cold weather military training exercise, 31 military personnel (mean±SD age: 26±5 y, height: 180±10 cm, weight: 83.2±10.9 kg) completed a 10-min immersion in cold (0°C) water and subsequently rewarmed for 60 min using 3 different field rewarming techniques (sleeping bag, sleeping bag + warm fluids, or exercise). Heart rate, core and skin temperatures, thermal and shivering sensations, and manual dexterity (intravenous setup and insertion) were measured during the training exercise. RESULTS Cold water immersion decreased core temperature (pre: 37.4±0.4; post: 36.4±1.0°C; P<0.001) and mean skin temperature (pre: 27.9±1.3; post: 15.6±1.8°C; P<0.001) and impaired manual dexterity (intravenous insertion time, pre: 71±12, post: 166±48 s; P<0.001). Recovery from mild cold stress was similar among all 3 rewarming techniques for all measurements. CONCLUSIONS Findings suggesting similar rewarming responses in field settings are beneficial for the warfighter, and perhaps others, in that rewarming options exist and can be implemented with no compromise in recovery from cold stress.
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Affiliation(s)
- Douglas Jones
- Leidos, Inc., San Diego, CA; Warfighter Performance Department, Naval Health Research Center, San Diego, CA.
| | - Justin Bowles
- Marine Corps Mountain Warfare Training Center, Bridgeport, CA
| | - Dale Bergquist-Turori
- Leidos, Inc., San Diego, CA; Warfighter Performance Department, Naval Health Research Center, San Diego, CA
| | - Christina Cooper
- Leidos, Inc., San Diego, CA; Warfighter Performance Department, Naval Health Research Center, San Diego, CA
| | - Kaitlyn Rostomily
- Leidos, Inc., San Diego, CA; Warfighter Performance Department, Naval Health Research Center, San Diego, CA
| | | | - Jay Heaney
- Warfighter Performance Department, Naval Health Research Center, San Diego, CA
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Flush Drowning as a Cause of Whitewater Deaths. Wilderness Environ Med 2020; 31:11-15. [PMID: 32057630 DOI: 10.1016/j.wem.2019.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 09/06/2019] [Accepted: 09/30/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Most recreational whitewater fatalities are caused by fixed underwater entrapment or by "flush drowning," an obscure term frequently associated with high-volume rivers, continuous rapids, cold water, and a lack of prolonged underwater entrapment. Although entrapment drowning is typically associated with submersion hypoxia, flush drownings likely involve diverse mechanisms of death; as such, a concise definition is elusive. This said, certain risk factors may be predictively associated with flush drownings. We attempt to further characterize causes of fatal river accidents and possible effects of water temperature on injury pattern. METHODS We reviewed river mortality data collected from the American Whitewater Association accident database comparing fatal whitewater accident trends in the Rocky Mountain region versus the Southeastern United States. We limited data from the Southeast to the months of June through August to create a warm water cohort. We then divided lethal accidents into flush drowning, entrapment submersion, or miscellaneous events, defining each category in specific terms. RESULTS Flush drownings were more common in the Rocky Mountains than in the Southeast subgroup and involved older victims on average than entrapment drowning or miscellaneous events. Entrapment drownings were common in both regions, primarily occurring at fallen trees or rock formations. CONCLUSIONS Flush drownings appear to occur more frequently in older persons. Although hypothetical, the relative increase in flush drowning in the Rocky Mountains might partly be the result of colder water temperatures. If the cause of flush drowning is better understood, safety in whitewater recreation may be improved.
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Manolis AS, Manolis SA, Manolis AA, Manolis TA, Apostolaki N, Melita H. Winter Swimming. Curr Sports Med Rep 2019; 18:401-415. [DOI: 10.1249/jsr.0000000000000653] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Jones DM, Bailey SP, De Pauw K, Folger S, Roelands B, Buono MJ, Meeusen R. Evaluation of cognitive performance and neurophysiological function during repeated immersion in cold water. Brain Res 2019; 1718:1-9. [PMID: 31047884 DOI: 10.1016/j.brainres.2019.04.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 03/13/2019] [Accepted: 04/28/2019] [Indexed: 11/30/2022]
Abstract
Exposure to cold causes disturbances in cognitive performance that can have a profound impact on the safety, performance, and success of populations that frequent cold environments. It has recently been suggested that repeated cold stress, resulting in cold acclimation, may be a potential strategy to mitigate the cognitive impairments frequently seen upon exposure to cold temperatures. The purpose of this study, therefore, was to examine cognitive and neurophysiological function during repeated cold water immersion. Twelve healthy participants consisting of 8 males and 4 females (mean ± SD age: 26 ± 5 years, height: 174.0 ± 8.9 cm, weight: 75.6 ± 13.1 kg) completed seven 90-minute immersions in 10 °C water, each separated by 24 h. During immersions 1, 4, and 7, a double-digit addition task and a computer-based psychomotor vigilance task (PVT) were administered to assess cognitive performance, while neurophysiological function was assessed using electroencephalography (EEG) measurements collected during the PVT. Findings suggest that participants experienced an insulative type of cold acclimation, evidenced by greater heat retention and less shivering, with possible improvements in cognitive performance. Participants had more correct responses on the double-digit addition task on Immersion 7 (39 ± 5) compared with Immersion 1 (33 ± 6); p < 0.001, yet no differences were observed for reaction time between Immersion 7 (286 ± 31 ms) and Immersion 1 (281 ± 19 ms); p = 0.59. Additionally, EEG analyses indicate no beneficial changes in neurophysiological function. Results demonstrate that individuals who are frequently exposed to cold water may be more suited to handle certain cognitive challenges after several exposures, although additional investigations are needed to provide neurophysiological support for this.
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Affiliation(s)
- Douglas M Jones
- Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussel, Belgium; San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, United States.
| | - Stephen P Bailey
- Elon University, 100 Campus Drive, Elon, NC 27244, United States
| | - Keven De Pauw
- Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussel, Belgium
| | - Steve Folger
- Elon University, 100 Campus Drive, Elon, NC 27244, United States
| | - Bart Roelands
- Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussel, Belgium
| | - Michael J Buono
- San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, United States
| | - Romain Meeusen
- Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussel, Belgium
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Parkes MJ. Time to elaborate on some of Scholander's ideas: Does even a rudimentary form of the response of diving mammals exist in humans? HISTORY AND PHILOSOPHY OF THE LIFE SCIENCES 2019; 41:32. [PMID: 31456051 DOI: 10.1007/s40656-019-0273-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 08/19/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Michael John Parkes
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Cold Water Immersion Syndrome and Whitewater Recreation Fatalities. Wilderness Environ Med 2019; 30:321-327. [PMID: 31178366 DOI: 10.1016/j.wem.2019.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/19/2019] [Accepted: 03/25/2019] [Indexed: 11/23/2022]
Abstract
Sudden death during whitewater recreation often occurs through understandable mechanisms such as underwater entrapment or trauma, but poorly defined events are common, particularly in colder water. These uncharacterized tragedies are frequently called flush drownings by whitewater enthusiasts. We believe the condition referred to as cold water immersion syndrome may be responsible for some of these deaths. Given this assumption, the physiologic alterations contributing to cold water immersion syndrome are reviewed with an emphasis on those factors pertinent to flush drowning.
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Gibson OR, Taylor L, Watt PW, Maxwell NS. Cross-Adaptation: Heat and Cold Adaptation to Improve Physiological and Cellular Responses to Hypoxia. Sports Med 2018; 47:1751-1768. [PMID: 28389828 PMCID: PMC5554481 DOI: 10.1007/s40279-017-0717-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
To prepare for extremes of heat, cold or low partial pressures of oxygen (O2), humans can undertake a period of acclimation or acclimatization to induce environment-specific adaptations, e.g. heat acclimation (HA), cold acclimation (CA), or altitude training. While these strategies are effective, they are not always feasible due to logistical impracticalities. Cross-adaptation is a term used to describe the phenomenon whereby alternative environmental interventions, e.g. HA or CA, may be a beneficial alternative to altitude interventions, providing physiological stress and inducing adaptations observable at altitude. HA can attenuate physiological strain at rest and during moderate-intensity exercise at altitude via adaptations allied to improved O2 delivery to metabolically active tissue, likely following increases in plasma volume and reductions in body temperature. CA appears to improve physiological responses to altitude by attenuating the autonomic response to altitude. While no cross-acclimation-derived exercise performance/capacity data have been measured following CA, post-HA improvements in performance underpinned by aerobic metabolism, and therefore dependent on O2 delivery at altitude, are likely. At a cellular level, heat shock protein responses to altitude are attenuated by prior HA, suggesting that an attenuation of the cellular stress response and therefore a reduced disruption to homeostasis at altitude has occurred. This process is known as cross-tolerance. The effects of CA on markers of cross-tolerance is an area requiring further investigation. Because much of the evidence relating to cross-adaptation to altitude has examined the benefits at moderate to high altitudes, future research examining responses at lower altitudes should be conducted, given that these environments are more frequently visited by athletes and workers. Mechanistic work to identify the specific physiological and cellular pathways responsible for cross-adaptation between heat and altitude, and between cold and altitude, is warranted, as is exploration of benefits across different populations and physical activity profiles.
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Affiliation(s)
- Oliver R Gibson
- Centre for Human Performance, Exercise and Rehabilitation (CHPER), Brunel University London, Uxbridge, UK. .,Welkin Human Performance Laboratories, Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Denton Road, Eastbourne, UK.
| | - Lee Taylor
- Athlete Health and Performance Research Centre, ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Peter W Watt
- Welkin Human Performance Laboratories, Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Denton Road, Eastbourne, UK
| | - Neil S Maxwell
- Welkin Human Performance Laboratories, Centre for Sport and Exercise Science and Medicine (SESAME), University of Brighton, Denton Road, Eastbourne, UK
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Saycell J, Lomax M, Massey H, Tipton M. Scientific rationale for changing lower water temperature limits for triathlon racing to 12°C with wetsuits and 16°C without wetsuits. Br J Sports Med 2018; 52:702-708. [PMID: 29720479 DOI: 10.1136/bjsports-2017-098914] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To provide a scientific rationale for lower water temperature and wetsuit rules for elite and subelite triathletes. METHODS 11 lean, competitive triathletes completed a 20 min flume swim, technical transition including bike control and psychomotor testing and a cycle across five different wetsuit and water temperature conditions: with wetsuit: 10°C, 12°C and 14°C; without wetsuit (skins): 14°C and 16°C. Deep body (rectal) temperature (Tre), psychomotor performance and the ability to complete a technical bike course after the swim were measured, as well as swimming and cycling performance. RESULTS In skins conditions, only 4 out of 11 athletes could complete the condition in 14°C water, with two becoming hypothermic (Tre<35°C) after a 20 min swim. All 11 athletes completed the condition in 16°C. Tre fell further following 14°C (mean 1.12°C) than 16°C (mean 0.59°C) skins swim (p=0.01). In wetsuit conditions, cold shock prevented most athletes (4 out of 7) from completing the swim in 10°C. In 12°C and 14°C almost all athletes completed the condition (17 out of 18). There was no difference in temperature or performance variables between conditions following wetsuit swims at 12°C and 14°C. CONCLUSION The minimum recommended water temperature for racing is 12°C in wetsuits and 16°C without wetsuits. International Triathlon Union rules for racing were changed accordingly (January 2017).
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Affiliation(s)
- Jane Saycell
- Extreme Environments Laboratory, Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Mitch Lomax
- Extreme Environments Laboratory, Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Heather Massey
- Extreme Environments Laboratory, Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
| | - Mike Tipton
- Extreme Environments Laboratory, Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK
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Barwood MJ, Corbett J, Massey H, McMorris T, Tipton M, Wagstaff CRD. Acute Anxiety Predicts Components of the Cold Shock Response on Cold Water Immersion: Toward an Integrated Psychophysiological Model of Acute Cold Water Survival. Front Psychol 2018; 9:510. [PMID: 29695988 PMCID: PMC5904285 DOI: 10.3389/fpsyg.2018.00510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 03/26/2018] [Indexed: 02/05/2023] Open
Abstract
Introduction: Drowning is a leading cause of accidental death. In cold-water, sudden skin cooling triggers the life-threatening cold shock response (CSR). The CSR comprises tachycardia, peripheral vasoconstriction, hypertension, inspiratory gasp, and hyperventilation with the hyperventilatory component inducing hypocapnia and increasing risk of aspirating water to the lungs. Some CSR components can be reduced by habituation (i.e., reduced response to stimulus of same magnitude) induced by 3–5 short cold-water immersions (CWI). However, high levels of acute anxiety, a plausible emotion on CWI: magnifies the CSR in unhabituated participants, reverses habituated components of the CSR and prevents/delays habituation when high levels of anxiety are experienced concurrent to immersions suggesting anxiety is integral to the CSR. Purpose: To examine the predictive relationship that prior ratings of acute anxiety have with the CSR. Secondly, to examine whether anxiety ratings correlated with components of the CSR during immersion before and after induction of habituation. Methods: Forty-eight unhabituated participants completed one (CON1) 7-min immersion in to cold water (15°C). Of that cohort, twenty-five completed four further CWIs that would ordinarily induce CSR habituation. They then completed two counter-balanced immersions where anxiety levels were increased (CWI-ANX) or were not manipulated (CON2). Acute anxiety and the cardiorespiratory responses (cardiac frequency [fc], respiratory frequency [fR], tidal volume [VT], minute ventilation [E]) were measured. Multiple regression was used to identify components of the CSR from the most life-threatening period of immersion (1st minute) predicted by the anxiety rating prior to immersion. Relationships between anxiety rating and CSR components during immersion were assessed by correlation. Results: Anxiety rating predicted the fc component of the CSR in unhabituated participants (CON1; p < 0.05, r = 0.536, r2= 0.190). After habituation immersions (i.e., cohort 2), anxiety rating predicted the fR component of the CSR when anxiety levels were lowered (CON2; p < 0.05, r = 0.566, r2= 0.320) but predicted the fc component of the CSR (p < 0.05, r = 0.518, r2= 0.197) when anxiety was increased suggesting different drivers of the CSR when anxiety levels were manipulated; correlation data supported these relationships. Discussion: Acute anxiety is integral to the CSR before and after habituation. We offer a new integrated model including neuroanatomical, perceptual and attentional components of the CSR to explain these data.
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Affiliation(s)
- Martin J Barwood
- Department of Sport, Health and Nutrition, Leeds Trinity University, Leeds, United Kingdom
| | - Jo Corbett
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Heather Massey
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Terry McMorris
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Mike Tipton
- Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, United Kingdom
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